Human health risks associated with the consumption of groundwater in the Gaza Strip

Groundwater of the Gaza Strip, the main source of drinking water for the Gazans, is highly contaminated by several chemicals of natural and anthropogenic origins. The results of this study confirm the findings of several studies conducted over the past two decades. Over those two decades, the population of Gaza has doubled, resulting in heavy demand for the limited reserves of groundwater. After 20 years since the first comprehensive study, it was found that groundwater salinity increased by 30 %, due to seawater intrusion. On the other hand, nitrate (NO₃) decreased by 30 %, due to expansion of the sewer network and decrease in the number and distribution of septic tanks. Salinity, chloride (Cl), NO₃ and fluoride (F) distribution maps for the year 2022 are very similar to those of the year 2002. This indicates that sources and loads of such contaminants are still the same. Metals and metalloids are still within the permissible limits set by the World Health Organization (WHO). Strontium (Sr) only showed concentrations of 12 mg/L across the Gaza Strip, which calls for further investigations. Maximum concentrations of the NO₃ and F were 365 and 2.6 mg/L, respectively. The results of probabilistic risk assessment using Monte Carlo simulation showed that NO₃ and F consumption through drinking water were above the reference dose for 35 % and 5 % of the trials performed, respectively. Consequently, the hazard quotient (HQ) is larger than 1 for 35 % and 5 % of the exposure scenarios simulated for these ions. For all metals and metalloids analyzed, HQ were below one (HQ1) indicating no risk; however, Sr presented an HQ 95th percentile equal to 0.19. Exposure routes such as dietary intake and soil ingestion, among others, should be further investigated to ensure that cumulative exposure does not surpass the safety limit. Recent advances in desalination technology should put an end to this truly regrettable situation.